A biased look at psychology in the world

January 25, 2011

What is Psychological First Aid?

It's become a familiar sight following disasters (both natural and man-made). Immediately after the disaster occurs, counsellors are often brought on the scene to engage in psychological debriefing designed to minimize the impact of traumatic experiences on those affected. Still, there is an active debate over the potential benefits of psychological debriefing (aso known as Critical Incident Stress Debriefing). Critics often argue that re-exposing victism to traumatic memories too soon after the disaster may do more harm than good. The popular media is filled with articles describing how improperly applied debriefing techniques can worsen long-term outcomes in some victims of traumatic stress. Frequently, leaving victims to recover with family and friends may be more effective. Even scientific reviews have yielded conflicting findings concerning the actual benefits associated with psychological debriefing techniques.

In a compelling recent article, psychologist Phillip Stacey has argued that psychological debriefing does not represent the current standard of care due to lessons learned from recent disasters such as the Boxing Day tsunamic, Hurricane Katrina, and the recent flooding in Australia. The new standard practice, known as Psychological First Aid, embraces the following core principles:

1) Respectful contact with survivors and observation of immediate needs;

2) Restoring a sense of safety to reduce distress and providing emotional and physical comforts away from trauma;

3) Stabilisation or calming of those who are emotionally overwhelmed using basic psychological interventions;

4) Gathering information for immediate action or later referral for appropriate care;

5) Planning practical assistance - survivors with favourable outcomes are characterised by optimism, confidence and resources and psychological care can help to foster these;

6) Cultivating connection with social supports to help speed recovery;

While most trauma victims often recover without psychotherapy, disaster survivors can experience a broad range of symptoms which may cause distress Supportive counseling is especially beneficial for those experiencing symptoms of anxiety, post traumatic symptoms, insomnia, or depression. Psychological First Aid strategies can also be used for children, adolescents, parents or guardians, or even first responders and other disaster relief workers. After an individualized assessment and treatment plan, trained mental health professionals may assist trauma victims in learning to deal with painful memories and developing proper coping strategies. To assist with proper administration of psychological first aid techniques, the United States Department of Veteran Affairs and the National Center for PTSD have developed a Field Operational Guide that can be downloaded here (PDF format). Along with formal guidelines for first responders, primary and emergency health care providers, and disaster relief organizations, the guide also includes Handouts for Survivors and a set of appendices describing additional resources available for use. Hardcopies of the Field Guide can also be ordered directly.